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GI Flashcards

0
Q
  • intermittent watery diarrhea, abdominal distension, anorexia, afebrile
  • h/o drinking bad water on camping trip or attending daycare
  • Dx: ELISA
  • Tx: metronidazole
A

Girardia Lamlia

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1
Q
  • absence of air in the RLQ

- finding suggestive of appendicitis

A

Sentinel loop

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2
Q
  • renal failure
  • thrombocytopenia
  • hemolytic anemia
A

HUS

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3
Q
  • green malodorous stools 2d after a picnic

- osteomyelitis in a SickleCell pt

A

Salmonella

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4
Q
  • fever, HA, abd pain, muscle aches, and Rose spots

- Tx: CTX & Cefotaxime

A

Typhoid fever

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5
Q
  • onset of illness several days after ingestion
  • watery diarrhea & fever –> bloody diarrhea
  • bandemia in absence of incr WBC
  • seizures
  • Tx: Bactrim
A

Shigella (shake-ella)

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6
Q

-produces vasoactive intestinal peptides that can cause diarrhea

A

Neuroblastoma

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7
Q
  • due to fruit juices and excessive water intake
  • MC cause of chronic diarrhea up to age 3
  • formed stool in am becoming progressively looser
  • growth and development are normal
A

Toddler’s Diarrhea

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8
Q

-PLE–>hypoproteinemia, steatorrhea, hypogammaglobulinemia, lymphedema, and lymphopenia

A

Intestinal lymphangectasia

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9
Q
  • non bilious emesis in a neonate
  • manifests within the first 6 months
  • h/o polyhydramnios & LBW
  • Dx: US
  • Tx: surgical
  • radiolucent filling defect in the pre pyloric region
A

antral web

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10
Q
  • MC in males than females
  • progressive non-bilious vomiting
  • MC 1 month after birth (up to 5 mos)
  • Dx: US showing hypertrophied pylorus
  • Tx: surgical
  • hypochloremic metabolic acidosis
A

Pyloric stenosis

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11
Q
  • bilious vomiting the first day of life
  • icteric (diminished enterohepatic circulation)
  • double bubble sign
A

Duodenal atresia

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12
Q

-bilious vomiting, abdominal pain, distension, passing blood via rectum

A

Malrotation

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13
Q
  • infant with bilious vomiting, R sided abd distension

- Xray: gastric and duodenal dilatation, decr intestinal air & corkscrew appearance of the duodenum

A

Volvulus

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14
Q

-dystonic movements of the head and neck along with GER

A

Sandifer syndrome

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15
Q
  • early schoolage child with episodes of vomiting separated by asymptomatic periods
  • emotional overtones, at risk for migraines & IBS
A

Cyclic vomiting

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16
Q
  • frequent regurgitation of ingested food into the mouth, then rechewed & swallowed or spit out
  • appear calm during episodes
  • seen in infants of severely disturbed moms
  • induce vomiting to seek attention
  • Tx: resolving the emotional trigger
A

Rumination

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17
Q

-forceful vomiting, wt loss, dysphagia, FTT

A

Achalasia

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18
Q
  • cyst in the floor of the mouth

- Tx: excision

A

Ranula

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19
Q
  • underdeveloped or absent teeth
  • Dx: skin Bx where no sweat pores are noted
  • X-linked
  • absence of sweat glands
A

Ectodermal hypoplasia

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20
Q

-underdeveloped small teeth

A

Hallermann Streiff Syndrome

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21
Q
  • bright red bloody or tarry stools, hematemesis

- liver disease–>portal HTN

A

Esophageal Varices

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22
Q
  • present with coughing with feeding in the newborn period
  • Xray: feeding tube coiled up in the esophagus
  • MC: upper esophageal pouch
  • copious oral secretions, polyhydramnios, coughing and cyanosis with feeding, inability to pass an NG
  • Tx: NPO & drain the blind pouch
A

TE fistula

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23
Q
  • gastrin secreting tumor
  • Sx: related to PUD
  • Dx: fasting gastrin levels
A

Zollinger Ellison Syndrome

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24
Q
  • bulky, pale, frothy, and foul smelling stools
  • proximal muscle wasting, abd dist
  • gluten sensitive enteropathy
  • Dx: Bx, antigliadin or anti endomysial Ab
A

Celiac Disease

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25
Q
  • worse diarrhea in the am
  • emotional component
  • high fiber diet & attn to emotional factors
A

Irritable Bowel Syndrome

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26
Q
  • associated with small bowel resection, parasites, or IBD

- w/u: CBC

A

B12 deficiency and pernicious anemia

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27
Q

-malabsorption, hyponatremia, rectal prolapse, meconium plug, fat soluble vitamin deficiency

A

GI manifestations of CF

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28
Q
  • extra teeth, polyps in the large and small intestine (pre-malignant), osteomas
  • Autosomal dominant
  • Tx: surgical
A

Gardner Syndrome

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29
Q
  • mucosal pigmentation of lips and gums + polyps

- Tx: polypectomy

A

Peutz-Jeghers Syndrome

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30
Q
  • teen with crampy lower abdominal pain w/wo bloody stools
  • fever, hypoalbuminemia, anemia
  • Ashkenazi Jews are at risk
  • associate with HLA B27 and ankylosing spondylitis
  • Tx: 5-ASA, steroids, MTX, cyclosporine
  • arthritis, mucocutaneous lesions, liver disease
A

Ulcerative Colitis

31
Q
  • wt loss, incr ESR
  • skip lesions, cobblestoning on EGD, transmural lesions, non-caseating granulomas
  • pyoderma gangrenosum, erythema nodosum, ankylosing spondylitis, arthritis, uveitis, liver disease, renal stones
  • Tx: steroids, 5-ASA
  • aphthous ulcers, perianal fistulas
A

Crohn Disease

32
Q
  • sudden onset severe intermittent colicky abd pain with asymptomatic episodes
  • drawing up legs and vomiting
  • may be relieved with passage of stool
  • bloody stool & sausage like mass
  • Tx: air enema
A

Intussusception

33
Q
  • delayed passage of meconium as newborn
  • constipation or intermittent loose stools
  • Dx: rectal Bx
  • Tx: surgical excision of aganglionic segment, colostomy & end to end anastamosis
A

Hirschprung Disease

34
Q

-test for lower GI bleed to determine if blood is mom’s or baby’s

A

Apt test

35
Q

-MC cause of lower GI bleeding in children 1-2 years of age

A

Anal fissure

36
Q
  • bloody diarrhea in a child from an Indian reservation or other rural areas in the South, Central, and SW US
  • Dx: serology
  • Tx: Flagyl
A

Entamoeba hiistolytica

37
Q
  • presents at age 2
  • 2 types of tissue (gastric and intestinal)
  • 2 feet from ileocecal valve
  • 2 inches in length
  • 2% of the population
  • painless rectal bleeding
  • Tx: surgical
A

Meckels Diverticulum

38
Q
  • incr direct bili, pale stools, hepatomegaly
  • Causes: liver/parenchymal disease or anatomical/obstructive disease
  • Dx: HIDA scan
  • MC in newborn–>TPN
A

Cholestatic jaundice

39
Q
  • incr direct bili over 1 mo age
  • Dx: US–>HIDA–>Bx
  • Tx: Kasai before 2 mos age
A

Biliary Atresia

40
Q
  • intermittent incr serum bili w/ illness/stress
  • simliar Hx in family members
  • glucuronyl transferase deficiency
A

Gilbert Syndrome

41
Q
  • recent URI in which ASA was given

- encephalopathy, coma, incr LFTs, and ammonia

A

Reye Syndrome

42
Q
  • hepatitis, RTA, AMS
  • KF rings
  • Tx: Penicillamine–>aplastic anemia
  • result of excess copper
A

Wilson Disease

43
Q
  • mid epigastric pain radiating to the back, rebound, and decr BS
  • Dx: abd US (most specific), lipase >amylase
A

Pancreatitis

44
Q

-jaundice, fever, palpable mass RUQ
Risks: hemolytic dz, TPN, sm intestine dz, obesity, pregnancy
-Dx: abd US
-Tx: surgical

A

Cholecystitis

45
Q
  • fecal oral transmission
  • household contacts and daycare centers
  • flu-like symptoms, incr LFTs, recent travel
  • Dx: serum IgM–>acute disease
A

Hepatitis A

46
Q
  • either acute HBV infection or chronic

- one of the earliest indicators of acute infx

A

HBsAg

47
Q

-previous HBV infx or positive immune response to immunization

A

Anti-HBsAg

48
Q

-high rate of infectivity and high rate of viral replication

A

HBeAg

49
Q

-indicates recent HBV infx (up to 6 mos after infx)

A

HBcAg IgM

50
Q
  • liver dz and cirrhosis
  • incr incidence of hepatocellular carcinoma
  • transmitted through blood and sex
A

Hepatitis C

51
Q
  • requires the presence of HBsAg to provide its outercoat

- chronic hepatitis or cirrhosis

A

Hepatitis D

52
Q
  • transmitted via fecal oral route
  • MC in Asia, Africa, and Mexico
  • exposure to contaminated water
A

Hepatitis E

53
Q
  • low pH
  • high pCO2
  • hypoventilation
  • CNS dysfunction
  • narcotics
A

Respiratory acidosis

54
Q
  • high pH
  • low pCO2
  • hyperventilation “blow off CO2”
  • triggered by hypoxia or high altitude
  • compensation thru incr bicarb resorption in kidneys
A

Respiratory alkalosis

55
Q
  • high pH
  • high bicarb
  • compensation by hypoventilation and holding onto CO2
A

metabolic alkalosis

56
Q
  • low pH
  • low bicarb
  • compensate with hyperventilation to decr CO2
A

Metabolic acidosis

57
Q
  • hypochloremic metabolic acidosis (incr pH)
  • loss of HCl
  • increased bicarb resorption in kidneys
  • low urine Cl (kidneys retain)
  • low Na
  • low or nl K
  • maybe hyperbili
A

Pyloric stenosis

58
Q 
Ureterostomy
Small bowel fistula
Extra chloride
Diarrhea
Carbonic anhydrase inhibitors
Adrenal insufficiency
Renal tubular acidosis
Pancreatic fistula
A

normal anion gap

59
Q
  • distal tubule does not excrete H+
  • urine: high pH >5.5
  • incr calciuria
  • normal bicarb (prox tubule ok)
  • mimicked by spironolactone)
A

Distal (Type 1) RTA

60
Q
  • proximal tubule unable to absorb bicarb
  • excessive bicarb in urine
  • distal tubule still releases H+
  • urine pH <5.5
  • mimicked by carbonic anhydrase inhibitiors
A

Proximal (Type 2) RTA

61
Q
  • aldosterone resistance or aldosterone deficiency
  • urine pH <5.5
  • hyperkalemia
A

Type 4 RTA

62
Q 
Methanol
Uremia
DKA
Paraldehyde
Ingestion/INH
Lactic acid
Ethanol/Ethylene glycol
Salicylates
A

Elevated anion gap metabolic acidosis

63
Q
  • healthy appearing infant at birth
  • lethargy, poor feeding, seizures
  • low WBC & plts
  • elevated serum ammonia
  • hypertension
  • elevated anion gap
A

Organic acidemia (proprionic or methylmalonic acidemia)

64
Q
  • hyperammonemia

- NO metabolic acidosis

A

Urea Cycle Defects

65
Q
  • incr serum Osm
  • dilute urine
  • Tx: drink H20, DDAVP if central
  • -incr Na, Cl, BUN, decr SpGr
A

Diabetes Insipidus

66
Q
  • dilute urine
  • hypernatremic dehydration
  • X-linked- found in males
  • fails to respond to DDAVP
A

Nephrogenic DI

67
Q
  • hypernatremia

- low urine Na (kidneys hold onto Na)

A

GI losses–>hypoNa

68
Q
  • hyponatremia
  • fluid retention, decr UOP
  • incr urine Osm and incr urine Na
  • Tx: fluid restriction, Demeclocycline (inhibits ADH secretion from kidneys)
  • decr Na, Cl, BUN, incr SpGr
A

SIADH

69
Q
  • hyponatremia
  • no volume depletion
  • seizures from cerebral edema
  • incr urine Na concentration (total body Na is nl)
A

Water intoxication

70
Q
  • low serum Na
  • incr TG or plasma prot, or gluc (Nephrotic Syndrome)
  • edema
  • incr total body Na ***
  • nl Cl, BUN, SpGr
A

Pseudohyponatremia

71
Q
  • weakness and paralysis
  • constipation and ileus
  • GI or renal losses
  • EKG: flattened T waves or U wave, ST depression, PVCs
A

Hypokalemia

72
Q
  • Causes: renal failure, cell breakdown, excess intake, redistribution
  • EKG: peaked T waves, absence of p waves, widened QRS
  • Treatment: insulin and glucose, Sodium bicarb, Albuterol, Lasix, oral polystyrene, ***CaGluc
A

Hyperkalemia

73
Q

UNa SCr/ UCr SNa
<1.5 low urine Na loss (pre renal azotemia)
>2.5 high urine Na loss

A

FeNa

74
Q

-GI losses, given tea or water
-seizures
-poor skin turgor
-more symptomatic on presentation
-Tx: :3% saline (desired Na - measured Na) x wt x 0.6 = A
A + maintenance (3mEq/kg/day = replacement
-pontine damage
-decr Na, Cl, incr BUN, SpGr

A

Hyponatremic dehydration

75
Q
  • Cause: Na gain or water loss –> incr Na in ECF
  • improper feeding
  • Sx: doughy skin, high pitched cry, irritable, lethargy, seizures (remember Noah Lynch)
  • Tx: assume 10% dehydration
  • clinical picture is deceptively good
  • risk for cerebral edema with correction
  • incr Na, Cl, BUN, SpGr
A

Hypernatremic dehydration

76
Q
  • decr Na, incr Cr
  • incr UOP
  • Incr UNa, incr UOsm
  • Tx: replace fluid and GI losses
A

Cerebral salt wasting

Peds Boards (23 decks)

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